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Same-Day Knee Surgery: What to Expect

How Same-Day Knee Surgery Works

Knee replacement surgery is a big decision that creates an understandable amount of apprehension. 

Fully understanding the entire same-day knee surgery process before deciding makes patients more comfortable with the idea of undergoing major surgery. 

At CORE, we like to fully educate our patients and make sure there are no surprises on the day of surgery.

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Leading Up to Surgery

Please note any current medical conditions, medications, medical and surgical history, and allergies. 

This is required to be done within 30 days of the procedure.

Two weeks before surgery, you will meet with Dr. Kuesis to review and discuss the process. 

In the week leading up to your surgery, there are a few important things to remember:

  • • No eating or drinking eight hours before surgery
  • • Do not take blood-thinning medications such as Advil, Aleve, Motrin, or blood-thinning products like Aspirin, Coumadin, etc. (any blood thinner prescribed by a doctor must get instructions on when and how to stop/resume).
  • • You should arrange for transportation post-surgery

You can access all necessary forms here, including further instructions and a patient checklist.

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Checking In for Surgery

Upon arrival, you will be led to your room, where our nurses review everything with you once more before signing the necessary consent forms. Please have your insurance card with you.

Once complete, you will change into your gown, and a nurse gets your IV started.

Finally, Dr. Kuesis will stop by to assign your knee (visibly mark the knee that will be operated on) and give you medication for relaxation.

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Day of Surgery

The medical professionals at CORE Orthopedics understand that knee replacement surgery is a big commitment. 

That’s why we’re committed to ensuring no surprises, especially on the day of surgery. 

Here’s what you can expect to happen during the knee replacement surgery process:

  1. 1. First, you’ll be admitted to the hospital or surgery center and complete any necessary intake paperwork/forms before you are taken back and given a room.
  2. 2. A nurse will record your vital signs — temperature, blood pressure, heart rate, etc.
  3. 3. You’ll be asked to change into a clean hospital gown. Your nurse will instruct you on what articles of clothing need to be removed. You might be allowed to leave on undergarments for comfort.
  4. 4. You’ll be asked to remove all jewelry, dentures, contact lenses, and nail polish if you haven’t done so already. We always recommend arriving at the site of your surgery with these things already removed to simplify your life.
  5. 5. You’ll be given an IV to administer fluids and medication during and after the procedure.
  6. 6. Your knee will be scrubbed and shaved to clean the area and prepare for surgery.
  7. 7. An anesthesiologist will discuss the type of anesthesia that will be used and administer it.
  8. 8. Your surgeon will confirm and initial the surgical site.
  9. 9. You will be given a sedative to help you relax.
  10. 10. You will be taken back to the OR suite

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After the Surgery

The postoperative process begins directly after your surgery when you are transported to the recovery room. 

CORE Orthopedics and Sports Medicine professionals closely monitor your vital signs and circulation. 

When you awaken, nurses help reorient you to your situation and ensure you are stabilized before moving you to your hospital room.

After arriving in your room and regaining alertness, you might notice the following unfamiliar things attached to your body:

  • • A large dressing, like gauze, applied to your incision to keep the area clean and absorb leaking fluid
  • • An IV that allowing you to receive fluids until you are eating and drinking on your own
  • • Occasionally, a catheter may need to be placed based on your response to anesthesia
  • • Elastic hose and/or a compression stocking sleeve to minimize the risks of clotting
  • • A knee immobilizer for extra protection until the second day

Depending on your overall health and your response to recovery, you’ll most likely be in the hospital for 2-3 days to monitor your pain and knee strength. 

You will either have an outpatient knee replacement in which you will recover at home and a therapist comes to the house for 1-2 weeks, or you will have an in-hospital stay. 

You’ll likely be prescribed pain pills and have a consultation with a physical therapist on the first day after surgery.

Once you’re released to go home, our team will send you off with a specific and detailed set of individualized recovery instructions. 

Much of the success of your knee replacement surgery depends on your participation in following these instructions correctly. 

You shouldn’t bathe or soak the surgical wounds for the first six weeks after surgery, and always keep the area clean and dry to promote healing.

It’s important to note that pain, swelling, and low-grade fever are common and standard for the first few weeks after surgery, and they will subside as the healing process progresses. 

To minimize swelling and maximize comfort, we recommend you elevate your knee for 30-60 minutes daily.

In the months following surgery, you’ll have follow-up appointments and physical therapy appointments to schedule making sure your recovery continues to go according to plan. 

Your doctor may also suggest a dietary plan and a period of time with a walker and/or crutches.

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Preventing Complications

For the most part, knee replacement surgery is extremely safe and effective — in fact, the surgeons at CORE Orthopedics and Sports Medicine have performed most knee replacement surgeries without complications.

However, it’s important to remember that we are talking about major surgery, and complications can occur in a small percentage of patients.

Educating yourself is the first step in proper preparation to prevent complications — check out the below list of potential issues you may face and the steps you can take to minimize their occurrence:

Thrombophlebitis

  • • Occurs when large veins of the leg form blood clots
  • • In some instances, these clots become lodged in the capillaries of the lung and cause pulmonary embolism
  • • Also known as deep vein thrombosis (DVT)
  • • Preventative measures include blood-thinning medication (anticoagulants), elastic stockings, and foot/ankle exercises that increase blood flow in the leg
  • • Compression stockings

Infection

Even when great care is taken to prevent infections before, during, and after surgery, they sometimes still occur in a small percentage of patients. Symptoms include pain or stiffness, swelling, warmth, redness around the wound, foul odor, increased drainage, fever, and fatigue.

*Report any of these symptoms immediately to your doctor

To prevent infection, take antibiotics as directed, complete the recommended dosage duration, and strictly follow the incision care guidelines your surgeon recommends.

Pneumonia

Can be caused during surgery as a result of the anesthesia, which makes your lungs “lazy” and leads to secretion buildup at the base of your lungs. 

Preventative measures include practicing deep breathing exercises and using an incentive spirometer for visual feedback while you breathe.

Knee stiffness

After surgery, your knee mobility might be restricted to the point where you develop a contracture in the joint. Symptoms of a contracture include significant stiffness during walking or other daily activities you may perform.

To prevent knee stiffness and maximize your range of motion, you should:

  • • Begin your physical therapy program early (day one or two) to start working on your range of motion exercises
  • • Use ice, compression stockings, and elevation to control edema and reduce swelling
  • • Control pain adequately so you can tolerate the rehabilitation regime

IMPORTANT: This information is not intended to replace medical advice. Make sure you discuss proper preventative care plans with your physician. 

Report these symptoms to your orthopedic surgeon or internist immediately if you develop swelling, redness, pain, and/or tenderness in the calf muscle after surgery.

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Rehabilitation Following Knee Replacement Surgery

When successful, knee replacement surgery is often a life-changing procedure that drastically improves the quality of life for many patients. 

However, to meet the surgery goals, it’s important that you take responsibility for your role in the rehabilitation process. 

Your surgeon will expect that you closely follow the after-care instructions they provide. 

You’ll also need to attend physical therapy appointments and work diligently on your own and with your therapist to achieve the best possible results. 

Here at CORE Orthopedics and Sports Medicine, we know the rehabilitation process following knee replacement surgery can be painful, but we urge you to commit to following your program. Here’s what you can expect to adhere to during rehabilitation:

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In the Hospital

  • • Ambulation with a walker or crutches depending on your weight-bearing status as determined by your surgeon
  • • Perform range-of-motion exercises
  • • Ice, compression, and elevation to control edema and swelling
  • • Instruction on an in-home exercise program
  • • Set discharge goals:
  • • Get in and out of bed independently
  • • Walking with a walker or crutches independently
  • • Walking up and down three steps independently
  • • Independent completion of your home exercise program
  • • Be able to bend your knee 90 degrees
  • • Be able to straighten your knee fully

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At Home

  • • Begin walking with a cane
  • • Continue continuous passive motion, range-of-motion exercises, and home exercise program.
  • • Care for the wound by keeping the incision clean and dry
  • • Monitor the wound closely for signs of infection

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Outpatient Physical Therapy

  • • Advanced strengthening program
  • • Add weights as tolerated
  • • Obtain a range of motion of the knee joint from 100-120 degrees
  • • Stationary cycling
  • • Walking program
  • • Aquatic therapy program
  • • Long-term Rehabilitation Goals
  • • Be able to walk or perform other low-impact physical activities with mild or no pain.
  • • Be independent in all activities of daily living.

All information provided on this website is intended for information purposes only. Each patient’s case is unique, and should follow his or her doctor’s instructions. Discuss nutrition, medication, and treatment options with your physician to ensure you get the proper care. If you are in an emergency, please call 911 and seek emergency help.

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In-Home Rehabilitation Exercises

For knee replacement surgery to achieve the best possible results, you’ll have to take control of the rehabilitation process. 

This process is important to keep up with your in-home exercises between physical therapy sessions. Here are some examples of good exercises you can do easily on your own that your physician might prescribe. The number of reps will be dependent upon your physician’s recommendation.

Leg Raises

  1. 1. Raise your leg six inches above the mat, keeping your knee straight.
  2. 2. Slowly and gently lower it.
  3. 3. Repeat.

Knee Extension

  1. 1. Place a pillow under your bent knee.
  2. 2. Lift your foot off the mat and lower it slowly.
  3. 3. Repeat.

Ankle Pumps

  1. 1. Flex ankle up and down.

Quadriceps Sets

  1. 1. Straighten your leg and tighten your thigh muscles.
  2. 2. Hold the contraction for five seconds.
  3. 3. Repeat.

Heel Slides

Make sure you’re wearing socks for this one.

  1. 1. Slide your heels backward towards your body to flex your hip and knee.
  2. 2. Return the knee to the straight position.

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